Surgical staplers and staple

ABSTRACT

The specification discloses a forming die or ram movable along a guideway or track by a pair of toggle-joint linkages to move from a column of staples a staple having a downwardly bowed central portion into engagement with an anvil, then bend outer portions down over the anvil to drive pointed legs into the flesh and bring the legs into alignment with each other. The column of staples is pressed by a spring arm and a follower toward the track and is laterally supported in a staple magazine. Each toggle-joint linkage is a one-piece member with two rigid arms connected by an undulating spring portion. The magazine is detachably connected to the track by spring latches or clips. Another stapler has a hook-like anvil, and the bowed central portion of the staple as it is pressed against the anvil by a forming die or ram, is first straightened and then bent legs are bent from the central portion, thus giving a &#34;soft&#34; initial feel to the stapling.

RELATED APPLICATION

This application is a continuation-in-part of my copending application,Ser. No. 899,350, filed Apr. 24, 1978, for IMPROVED SURGICAL STAPLER ANDSTAPLE and now abandoned.

DESCRIPTION

This invention relates to improved surgical staplers and an improvedsurgical staple, and has for an object thereof the provision of new andimproved surgical staplers and a new and improved surgical staple.

Another object of the invention is to provide surgical staplers that arevery reliable yet so inexpensive that each can be discarded after oneuse.

Another object of the invention is to provide a surgical stapler havinga magazine clipped to a cover and a base.

Another object of the invention is to provide a surgical stapler havinga magazine secured to a base by spring clips which also secure a coverto the base.

A further object of the invention is to provide a surgical staplerhaving a pair of toggle-joint linkage handles serving to drive a stapleforming ram.

Another object of the invention is to provide a surgical stapler havinga magazine pressing a stack of staples toward a guideway or track havinga support rib which engages the end staple of the stack to hold it fromaccidental movement.

Another object of the invention is to provide a surgical stapler havinga sheet metal anvil cupped to strengthen it and provide a roundedcontacting surface.

Another object of the invention is to provide a surgical stapler andstaple in which the force of stapling is initially soft.

Another object of the invention is to provide a surgical stapler whichis locked against actuation when its supply of staples has been used up.

Another object of the invention is to provide a stapler in which twoarms of a ram are spaced substantially from each side of an anvil toprovide good leverage in stapling.

Another object of the invention is to provide a surgical staple having areversely bowed central portion and two legs bent from the centralportion, so that by pressing the legs on opposite sides of the bowedportion, the bowed portion is first bent straight and then the legs arebent from the central portion.

In the drawings:

FIG. 1 is a perspective view of a surgical stapler forming oneembodiment of the invention;

FIG. 2 is an exploded perspective view of the stapler of FIG. 1 and astaple forming one embodiment of the invention;

FIG. 3 is a top plan view of the surgical stapler of FIG. 1;

FIG. 4 is a side elevation view of the surgical stapler of FIG. 1;

FIG. 5 is a bottom plan view of the surgical stapler of FIG. 1;

FIG. 6 is a front elevation view of the surgical stapler of FIG. 1;

FIG. 7 is a sectional view taken along line 7--7 of FIG. 3;

FIG. 8 is a fragmentary, front elevation view of the stapler of FIG. 1;

FIG. 9 is an enlarged, fragmentary, vertical section taken along line9--9 of FIG. 8;

FIGS. 10 and 11 are vertical, sectional views taken along lines 10--10and 11--11 of FIG. 3;

FIGS. 12, 13 and 14 are enlarged, fragmentary views of the stapler andstaple looking upwardly during the different steps in a staplingoperation;

FIG. 15 is a top plan view of the stapler with its magazine removed;

FIG. 16 is an enlarged, vertical, sectional view taken along line 16--16of FIG. 15;

FIG 17 is an enlarged, vertical, sectional view taken along line 17--17of FIG. 15 but without the staple;

FIG. 18 is an enlarged, fragmentary, sectional view, like FIG. 9, but ofa stapler forming an alternate embodiment of the invention; and

FIGS. 19, 20 and 21 are enlarged, fragmentary views, like FIGS. 12, 13and 14, but of the stapler of FIG. 18.

An improved surgical stapler 10 forming one specific embodiment of theinvention is adapted to staple improved surgical staples 12 forming analternate embodiment of the invention. The stapler includes a two-piecebody consisting of a cover 14 of stainless steel and a channel-like base16 I-shaped in transverse cross-section and of a tough plastic materialsuch as, for example, an acetal such as "DELRIN" or an acrylic material.The cover and the base form a guideway 18 for a plate-like die or ram 20of stainless steel, the ram being drivable by two, identical, manuallyoperable toggle-joint linkage handles 22 from a retracted position pasta stack or column 24 of the staples in a magazine 26 to move thelowermost staple out of the stack, along the guideway and intoengagement with an anvil 27 of the cover, and then form the staplearound the anvil to insert pointed legs 28 of the staple into a patient30 at opposite sides of a cut 32 to be sutured and bend top 34 of thestaple to form the staple into a rectangle. Pressure on the handles isreleased slightly and the anvil then is slid out from under the top ofthe suture. Then the remaining pressure on the handles 22 is releasedand the handles retract the ram 20, after which another staple is movedthrough the magazine 26 into the guideway for another staplingoperation.

The base 16 includes a hook 40 and a key 42 forming a socket-like end.The rear end portion of the cover 14 has a keying notch 44 that fitsover the key permittng the rearmost portions of the cover to fit underthe hook, thus interlocking the rearward ends of the cover and base.Holes 46 in the cover receive rear pins 48 on rear gussets or webs 50 ofrear arms 51 of the handles 22, and front pins 52 on front gussets orwebs 54 of front arms 55 of the handles fit in holes 56 in the ram 20.The cover has a raised clearance portion 57 for the pins 52. The ram isslidable between and guided by side flanges 58 of a channel-like,forwardly located guide portion 60 of the cover 14. The guideway 18 isformed by the guide portion 60 and side ribs 62 of the base 16. Astaple-supporting center rib 64 is provided on the base intermediate theside ribs 62 for frictionally engaging the lowermost staple 12 to keepit from moving along the guideway except by action of the ram. Thecenter rib has a shallow notch 66 for holding the staple againstaccidental movement along the guideway. The ribs 62 serve to support thelegs 28 of the staple. In one constructed stapler, the height of thecenter rib was 0.005 inches higher than the side ribs 62. The ram 20 hasa groove 68 to provide clearance for the rib 64.

The magazine 26 includes a pair of T-shaped lugs 70, which snap underhook portions of clips 72 of the base 16 to lock the cover 14 betweenthe base and the magazine. The magazine has a tab or key 74 whichextends into a hole 76 formed in the cover between a rib 78 of the coverand edge 80, a downwardly looped strap 82 being cut therefrom to formthe hole 76 and also serve as a rear stop for the ram. The forward oneof the clips 72 keeps the cover from moving forwardly relative to thebase. The magazine 26 has a guide or chute 84 for the stack 24 ofstaples 12, and a leaf spring 86 of acetal or nylon presses a follower88 against the stack to press the innermost one of the staples againstthe center rib 64. The leaf spring has a fulcrum tab 90 positioned inV-notch 92 and the leaf spring is trapped under lugs 94 on sidewalls 96of the magazine. Presser tab 98 bears against the inside end of thefollower, which is complimentary in shape to the chute 84. The chute 84includes outer, angular guide members 100 guiding outer corner portionsof the staple and inner ribs 102 guiding inner corner portions of thestaples. The cover 14 has an opening 104 through which the stackextends. The follower 88 extends through the opening into the path ofthe ram 20 when the ram has been retracted after the last staple hasbeen stapled, the follower then blocking movement of the ram, whichindicates to the user that the staples have all been used.

Each linkage handle 22 includes an undulating, flexible leaf-springportion 109 having finger or thumb recesses 112. The leaf-springportions hingedly connect the corresponding arms 51 and 55 and formcontinuations of wide, strip-like portions 115 of the arms, which arerigidified by the gussets 50 and 54.

The ram 20 includes a pair of forming tines 110 having rounded noses 113and aligned, shallow grooves 114 for receiving and centering portions116 of the staple. Edges 118 converge slightly, about 4°, toward eachother proceeding rearwardly. The rear end of the notch formed by thetines acts as a stop when it presses the central portion 130 of thestaple against the anvil to limit forward movement of the arm. The webs50 preferably have spring finger portions 120 acting as cushions orshock absorbers at the end of each stapling operation so that cushioningis provided.

The portions 116 of the staple 12 that are aligned with each other andare connected to a downwardly bowed central portion 130 so that they aresomewhat prebent toward each other as the central, bowed portion is bentstraight during the initial forming of a stapling operation, as shown inFIG. 13. Then the portions 116 are bent to right-angles with the centralportion 130.

As best shown in FIG. 9, the anvil is somewhat belled or cupped toconform to the bowed, central portion 13 of the staple, and is easilyslid out from under the portion 130 after a stapling operation.

EMBODIMENT OF FIGS. 18-21

A surgical stapler 210 forming an alternate embodiment of the inventionis identical to the stapler 10 except that an anvil 227 is straight,when viewed from one edge, rather than cupped and is somewhat hook-like.In the stapling operation, only the bowed central portion 130 of thestaple 12 first engages the anvil and is straightened. Then the portions116 are bent at right angles to the straightened central portion tocomplete the stapling. The force required to straighten the centralportion is low compared to that required to make right angle bends orcorners 231 so that only a "soft" initial feel or force is used to makethe required actuating force gradual rather than an abrupt, high force.It should be noted that tines 310, like the tines 110, are spacedsubstantially from the edges of the anvil to give high leverage informing the corners 231. Also, by having the bow and the portions 116aligned at the start the corners 231 are already started or prebentbefore any stapling occurs. This causes the tines to press on slopingportions 116 after the bowed portion is straightened. The ram hasrounded staple engaging portions 311 engaging the portions 116 duringthe formation of the corners 231. The portions 311 increase the wedgingeffect to keep the force low.

What is claimed is:
 1. In a surgical stapler,a channel-like base, a corner having a staple opening therethrough, the cover and the base having a ram guiding portion and a staple guiding portion and also being provided with an anvil, magazine means secured to the base and the cover in alignment with the opening for urging a stack of staples through the opening to position an end staple in the staple guiding portion, the magazine means being snap-fastened and interlocked to the base with the cover secured therebetween, a ram slidable along the ram guiding portion and the staple guiding portion to move the end staple to the anvil and bend the staple around the anvil, and means for driving the ram in response to a squeezing motion applied laterally in the plane of movement of the ram.
 2. The surgical stapler of claim 1 wherein the base and the magazine means have interlocking spring clip means securing the magazine means to the base.
 3. The surgical stapler of claim 2 wherein the magazine means traps the cover between the magazine means and the base and the spring clip means comprises clips provided on the base and extending past the sides of the cover to snap-fasten with lugs on the magazine.
 4. The surgical stapler of claim 1 wherein the base has a hook portion at its rearward end and the rearward end of the cover extends under the hook portion thereby trapping the rearward end of the driving means between the base and the cover.
 5. The surgical stapler of claim 1 wherein the cover has a second opening therein and the magazine means has a locating tab extending into the second opening.
 6. In a surgical stapler,a ram, elongated body means having a base and a cover forming a guideway for the ram to travel longitudinally therein, the cover having an opening for inserting staples into the guideway, an anvil disposed at a forward end of the body means in line with the guideway, manually operable drive means carried by the body means for driving the ram along the guideway toward the anvil, the drive means comprising at least one toggle-joint linkage mechanism, a magazine attached to the body means and having a staple chute adapted to hold a stack of staples and guide the staples through the opening into the guideway into the path of the ram, spring means adapted to press the stack of staples along the magazine toward the opening, and spring clip means disposed on cooperating portions of the base and the magazine to snap-fasten and interlock the magazine to the base with the cover secured therebetween.
 7. The surgical stapler of claim 6 wherein the toggle-joint linkage mechanism includes a first arm pivotally secured to the body means and a second arm pivotally connected to the ram at one end and hingedly connected at its other end to the first arm and including spring means urging the arms toward a folded condition.
 8. The surgical stapler of claim 7 wherein the spring means comprises a leaf spring that hingedly connects the arms together.
 9. The surgical stapler of claim 8 wherein the arms and the spring are integral.
 10. The surgical stapler of claim 9 wherein the spring is undulating in shape.
 11. The surgical stapler of claim 10 wherein the arms and the spring are of plastic material.
 12. In a surgical stapler,a ram, elongated body means having a base and a cover forming a guideway for the ram to travel longitudinally therein, the cover having an opening for inserting staples into the guideway, an anvil disposed at a forward end of the body means in line with the guideway, manually operable drive means carried by the body means for driving the ram along the guideway toward the anvil, a magazine attached to the body means and having a staple chute adapted to hold a stack of staples and guide the staples through the opening into the guideway into the path of the ram, spring means adapted to press the stack of staples along the magazine toward the opening, spring clip means disposed on cooperating portions of the base and the magazine to snap-fasten and interlock the magazine to the base with the cover secured therebetween, and retaining means extending longitudinally along the guideway for frictionally holding each staple that is moved by the ram out of alignment with the stack until the staple arrives at the anvil.
 13. The surgical stapler of claim 12 wherein the retaining means comprises a staple-supporting rib provided on the base along the center of the guideway.
 14. The surgical stapler of claim 12 wherein the spring means includes a follower slidable along the chute and a leaf spring having one end engaging the follower.
 15. The surgical stapler of claim 12 wherein the chute includes guide means adapted to engage portions of the staples proximate to their corners so that their pointed ends remain out of contact with the chute surfaces.
 16. The surgical stapler of claim 12 wherein the base has socket means at one end and the cover has an end portion fitting into the socket means.
 17. In a surgical stapler,elongated body means comprising a base and a cover and forming a guideway therebetween, staple-holding means attached to the body means near a forward end of the guideway for urging staples into the guideway, the staple-holding means being fastened and interlocked to the base with the cover secured therebetween, a ram slidable along the guideway, an anvil affixed at a forward end of the body means in front of the staple-holding means in the path of the ram, whereby a staple is formed around the anvil by the forward movement of the ram, and a pair of toggle-joint linkages, each pivotally secured at a rearward end of the body means and at a forward end to the ram, whereby the toggle-joint linkages move the ram forwardly along the guideway in response to a lateral squeezing motion applied to longitudinally extend the toggle-joint linkages.
 18. The stapler of claim 17 wherein the base and cover together form longitudinal side slots through which portions of the toggle-joint linkages extend to permit the forward ends thereof to move longitudinally within the side slots during actuation of the toggle-joint linkages.
 19. The stapler of claim 17 wherein each toggle-joint linkage includes front and rear arms joined by a flexible leaf-spring portion which is biased to return the linkage to a retracted position wherein the ram is rearward from the staples in the staple-holding means, the leaf-spring portions forming the joints of the respective toggle-joint linkages. 